Michigan Ski For Light - Visually Impaired Registration

Michigan Ski For Light
32900 Hees
Livonia, MI 48150
United States
ph: 734-612-4619
alt: 734-666-0814
ksridsdale@msfl.org

Visually Impaired Registration

*First Name:

*Last Name:

*Email:

*Phone:

*Address Line 1:

Address Line 2:

*City:

*State/Province:

*ZIP/Postal Code:

*Country:

*Room Type

RAM Center Standard Double Room with RAM Meals - $145.00 RAM Center Standard Single Room with RAM Meals - $200.00 No Room or Meals Required - $25.00

*Meal Type:

Standard Vegeterian

*Cross Country Ski Rental

Ski Rental - ADD $30.00 None required

Shoe Size

Your Height

Your Weight

*Transportation

Own Transportation Transportation needed (all transportation provided will be from a common pick-up and drop off location) - Add $20.00

*Experience Level

Beginer Intermediate Advanced

Special Needs and Comments:

Special needs

*Total Payment Due

Please make check payable to MSFL
Mail payment to
MSFL
32900 Hees St
Livonia, Michigan 48150

*Emergency Contact:

Name

Address

Phone

Relationship

*Medical Information

List of all Prescriptions, Dosages, and Frequencies.

*Approximate arrival time at the RAM Center

Submit Your Registration

Confirmation email of registration will be sent within 24 hours

Michigan Ski For Light
32900 Hees
Livonia, MI 48150
United States
ph: 734-612-4619
alt: 734-666-0814
ksridsdale@msfl.org